Provider Demographics
NPI:1194953752
Name:YOUNGER, COLE (DDS)
Entity type:Individual
Prefix:DR
First Name:COLE
Middle Name:
Last Name:YOUNGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 PORTICA
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-1223
Mailing Address - Country:US
Mailing Address - Phone:919-946-6626
Mailing Address - Fax:
Practice Address - Street 1:2121 E COAST HWY STE 160
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-1962
Practice Address - Country:US
Practice Address - Phone:949-688-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC88281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice